The Kombi Clinic – It’s the end of the road for Hepatitis C

Author: O’Loan J, O’Flynn M, Young M

Theme: Models of Care Year: 2019

With the advent of DAA therapy, the road to Hepatitis C elimination is no longer paved with
pharmacological riddles. Rather the challenge moving forward is to engage with populations that
are often disenfranchised, disempowered and socially isolated. We need to break down the
traditional barriers and provide unique models of care where treatment can be taken to the streets.
Description of model of care/intervention
The Kombi Clinic consists of two General practitioners, a nurse, a phlebotomist and of course our
1975 Yellow VW Kombi. We travel around South East Queensland (15 locations), providing an allinclusive ‘pop up’ style hepatitis clinic. The venues we visit target populations with an increased risk
of Hepatitis C and include drug rehab centres, homeless shelters and hostels as well as music
festivals and suitable public events. We provide medical consultations, full formal venesection and
fibroscan, meaning that it is a 2 visit process to start HCV treatment.
The Kombi Clinic has seen 681 individual patients and provided 1000’s occasions of service. 37.8% of
patients we test are HCV antibody positive, with 26.1% HCV RNA positive. Of those HCV RNA
positive, 133 patients (76.4%) are linked to care and receive DAA therapy. With our currently
available data, SVR12 was achieved in 95% of patients. Patient demographics including history of
injecting drug use will also be presented. This project has also reaffirmed the well-known truth that
Kombi Vans are rad!
Conclusion and next steps
Providing HCV testing and treatment in non-traditional settings is not just effective in achieving
comparable SVR12 rates, but it is essential in order to reach patients not currently engaged with
‘standard’ models of care. If we are to achieve our elimination goals we must make testing,
treatment and cure a simple process, we need to take treatment to the people.
Disclosure of interests
The Kombi clinic has received a competitive industry grant from Gilead fellowship award

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